Music therapy for end-of-life care: An updated systematic review

Abstract

Background: Music therapy during palliative and end-of-life care is well established

A Systematic Review in Support of the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care, Fourth Edition

“…Music/art therapy: However, there was moderatequality evidence from three reviews 51,69,94 demonstrating the positive impact of music/art therapy on a The GRADE category is based on identified systematic reviews published between 2013 and February 2018. We used the following reasons for downgrading confidence in the evidence (downgraded by 1 or 2): Study limitation (observational studies start with a low GRADE value), Inconsistency (individual studies do not come to the same conclusions or there is only one study so inconsistency cannot be evaluated), Imprecision (there is no effect estimate, there is no measure of dispersion, or the CI is very broad); we used the systematic review authors' evaluation for other GRADE criteria if there was a formal quality of evidence assessment (see text).…”

“…94 Another review found that music therapy was associated with a significant reduction in pain (SMD À0.42; CI À0.68, À0.17; three non-RCT studies). 69 Comprehensive palliative care: There was also moderate-quality evidence for the impact of a comprehensive palliative care team for adults on symptom burden. One review found that comprehensive palliative care was associated with a statistically and clinically significant reduction in symptom burden in adults with advanced illness at 1-to 3-month follow-up (SMD À0.66; CI À1.25, À0.07; 10 RCTs) and at 4-to 6-month follow-up (SMD À0.31; CI À0.05, À0.07; six RCTs.…”

“…Three reviews reported anxiety outcomes for music/art therapies. 51,69,94 One review reported that creative art therapies significantly reduced anxiety (SMD 0.28; CI 0.11e0.44; 25 RCTs) and depression (SMD 0.23; CI 0.05e0.40; 11 RCTs) compared to controls after intervention. 94 Another review found four studies (one RCTand three pre-post) demonstrating positive effects of music therapy on anxiety and three studies (one RCT and two pre-post) demonstrating reduced depression.…”

“…Continued SRs51,69,94 Three reviews reported pain management outcomes related to music/art therapies and all reported positive effects on pain management, while acknowledging differences across studies in control groups and pain assessment tools. One review found that exposure to creative arts and music therapies is shown to reduce pain postintervention compared to no treatment, waiting list, usual care, or placebo controls (SMD 0.54; CI 0.33, 0.75; 18 RCTs) and at follow-up (SMD 0.59; CI 0.41, 0.77; seven RCTs) 94.…”

Music Therapy During End-of-life Care in the Neonatal Intensive Care Unit (NICU) – Reflections from Early Clinical Practice in Colombia

“…However, while music therapy is widely applied for a variety of populations with terminal diseases including paediatrics (e.g. Archie, Bruera, & Cohen, 2013;Bradt & Dileo, 2010;Hilliard, 2005;McConnell, Scott, & Porter, 2016), no publications were found that specifically address music therapy during end-of-life care in the NICU. This suggests that it may not yet be a fully integrated aspect of clinical practice or a currently active field of research.…”